| NPI | 1134648272 |
|---|---|
| Former Name | ANNALISE POLKINGHORN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6851116506) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2017-09-10 |
| Last Update Date | 2024-10-04 |